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Biomedical subjects

P Ahmad

Publications and source records attributed to P Ahmad.

At least 19 recordsLinked to original sources

Impact of sedation and resident teaching on complications of colonoscopy.

There is controversy regarding the frequency of sedation-related complications of colonoscopies and whether these procedures are safely performed by physicians-in-training. We retrospectively reviewed the safety of 1,004 consecutive outpatient colonoscopies. No perforations occurred. No patients were hospitalized for sedation-related complications. Seventeen percent of patients had significant changes in vital signs that lasted less than 5 min. These changes were less common in patients receiving </=3 mg midazolam intravenously without meperidine (p < 0.005). Complications were slightly more frequent in procedures performed by trainees (23%) than by gastroenterologists (12%) and by surgeons (18%) (p = 0.01). These data support the safety of colonoscopy under intravenous sedation, even when performed by trainees.

Adolescent↗

Iron deficiency anaemia: continuous versus intermittent treatment in anaemic children.

Iron deficiency anaemia is a common disorder among paediatric population. Traditionally, oral iron is given for treatment on daily basis. We undertook this study to compare the results of intermittent with continuous oral iron therapy in children. The study was conducted at Combined Military Hospital (CMH), Lahore. Children (aged 1 to 6) with iron deficiency anaemia (Hb 11 g/dl) were allocated at random into two groups, A (n = 27) and B (n = 28). The mean Hb of group A, before treatment, was 8.56 (+/- 1.51) g/dl and that of group B was 8.32 (+/- 1.68) g/dl. Group A was given daily oral dosage of 6 mg/kg of elementAL iron whereas group B was given the same dosage of iron but only 3 days a week. After 2 months of treatment the Hb of group A rose to a mean of 11.06 (+/- 0.72) g/dl and that of group B was increased to 11.3 (+/- 0.90) g/dl, respectively. The difference, in the rise of Hb of two groups, was not statistically significant. It was concluded that in our sample of population, the results of intermittent and continuous oral iron therapy, for iron deficiency anaemia in children aged 1 to 6 years, were identical.

Anemia, Iron-Deficiency↗

A numerical investigation of the mechanics of swelling-type intramedullary hip implants.

The novel concept of swelling-type intramedullary hip implants that attain self-fixation by an expansion-fit mechanism resulting from controlled swelling of the implant (by absorption of body fluids) was examined in detail using a finite element model of the implant-femur system. Some of the potential advantages of this technique over traditional techniques include enhanced fixation, lower relative micromotions, improved bony ingrowth, and elimination of acrylic cement. The finite element model created in this study incorporated: (i) the major aspects of the three-dimensional geometry of the implant and femur, (ii) the anisotropic elastic properties of bone and implant materials and the changes in orientation of the principal axes of anisotropy along the length of the implant-femur system, (iii) a layer of cancellous bone between the implant and cortical bone in the proximal femoral region, and (iv) frictional sliding between the bone and implant. The model was used to study quantitatively the parametric influence of various material design variables on the micromotions and stress fields in the bone-swelling-type implant system. The results of the finite element analyses were used to establish material behavior goals and provide targets for a material development study.

Computer Simulation↗

Prognostic factors influencing mortality in meningococcal meningitis.

The clinical features and some laboratory parameters of 247 cases of meningococcal meningitis admitted between January 1983 and April 1990 to a paediatric ward in Jawahar Lal Nehru Medical College Hospital, India were analyzed retrospectively. A total of 189 (76.5%) were more than 5 years of age. The maximum number of cases occurred between October and April each year. Complications included bleeding tendencies, neurological deficits, gangrene of limbs, arthritis, uveitis and cataract. The overall mortality rate was 16%. A scoring system based on some clinical characteristics correctly predicted a fatal outcome in all but three children.

Adolescent↗

Increased oxidative metabolism in phytohemagglutinin-stimulated lymphocytes from patients with systemic lupus erythematosus is associated with serum SSA antibody.

We have examined oxidative metabolism in phytohemagglutinin (PHA)-stimulated lymphocytes from patients with systemic lupus erythematosus (SLE) because increased oxygen free radicals would explain the DNA abnormality previously observed in these cells. Almost no oxidative activity was found in freshly isolated control or lupus lymphocytes or control lymphocytes stimulated with PHA. However, increased oxidative metabolism, measured by nitroblue tetrazolium (NBT) conversion to formazan, was found in PHA-stimulated lymphocytes from 14 of 21 lupus patients. A time course study showed that NBT activity appeared in positive lupus lymphocytes at 1-2 days of PHA stimulation, increased to a maximum at 2-4 days, and diminished thereafter. NBT activity was not related to specific disease symptoms, drug therapy, or serum dsDNA, Sm, RNP, or SSB (La) antibodies. The selected population of lupus patients studied precluded conclusions about NBT activity and disease severity. However, the intensity of NBT response in stimulated lupus lymphocytes was positively correlated with the presence of serum SSA (Ro) antibody. We suggest that increased oxidative activity of SLE lymphocytes generates a chemical change in endogenous DNA in vivo and may be a primary event in the pathogenesis of autoimmunity. Absence of detectable oxidative activity in stimulated lymphocytes in a subgroup of lupus patients suggests that at least two different mechanisms are associated with the altered DNA profiles observed in this disorder.

Antibodies, Antinuclear↗

Use of flagellin-enriched antigens in a rapid, simple and specific quantitative enzyme immunoassay for Lyme disease antibodies in human serum samples.

An enzyme immunoassay (EIA, ELISA) using microwells coated with a flagellin-enriched fraction of B. burgdorferi and absorbent-containing sample diluent for the quantitative determination of Lyme disease (LD) IgG and IgM antibodies in human serum samples was described. This LD EIA required three 15-minute incubations at room temperature, followed by a 1-step normalization of photometer readings to EIA units (EU/ml). Compared with tests using the whole bacterial extract as antigens and a sample diluent containing 6% BSA, this new LD EIA revealed lower values for 20 syphilis (SS) and 21 normal serum samples (NS) but about the same for 21 Lyme disease (LD) samples, allowing lower cut-off points which would place almost all these SS and NS samples below while almost all LD samples above the positive cut-off point. The LD EIA results of larger numbers (67 to 291) of mixed samples correlated with results of four reference EIA. However, the LD EIA gave lower (2 to 4 fold) reactivities (index values) with SS and NS samples but higher values with positive serum samples than reference EIA. Thus, this LD EIA showed improvements in both specificity and sensitivity over other tests compared.

Adjuvants, Immunologic↗

C-reactive protein in CNS infection.

Serum and CSF levels of CRP were measured by radial immunoassay in 99 subjects consisting of 20 controls, 34 pyogenic meningitis (PM), 21 tuberculous meningitis (TBM) and 24 viral encephalitis (VE). There was significant difference in the CRP levels (p less than 0.01) depending on the type of disease in both serum and CSF. The initial serum and CSF levels of CRP in patients with TBM was intermediate between those of PM and VE and were found to be significantly (p less than 0.001) low when compared with three days post treatment levels in children with PM. Both serum and CSF-CRP levels were significantly high (p less than 0.001) in patients succumbing to death than those who survived. Measurement of CRP in serum and CSF is a useful parameter in differentiating partially treated PM from TBM.

Biomarkers↗

Blood-Pb and hair-Pb levels in donor-matched samples.

Lead concentrations in blood and scalp hair of 200 school boys, aged 6-8 years, were measured by electrothermal atomic absorption spectrometry. The mean blood-Pb concentration was 6.8 microg dl(-1) and the mean hair-Pb concentration was 9.7 microg g(-1) (dry weight). These values are well within the normal range for the respective tissues, indicating that the children studied are presently at relatively low risk from environmental lead pollution. A correlation analysis carried out on the data failed to show any statistically significant correlation (r = 0.13, p < 0.05) between the blood-Pb and hair-Pb concentrations.

Journal Article↗

Phagocyte metabolic functions in iron deficiency anaemia of Indian children.

Nitroblue tetrazolium test (NBT) and bactericidal activity of polymorphonuclear leucocytes was studied in 40 patients with iron deficiency anaemia (aged 0-12 years). NBT test had a significant correlation with serum iron (P less than 0.001) in all cases of iron deficiency anemia. Haemoglobin levels less than 4 g/dl also correlated significantly with NBT score. Bactericidal activity with opsonin-coated Staphylococcus aureus was considerably decreased in severe anaemia, but no significant correlation was found with serum iron concentration (P less than 0.1). The phagocytic and bactericidal activity of polymorphonuclear leucocytes is dependent upon serum iron levels and is considerably reduced in iron deficient state in anaemic children.

Anemia, Hypochromic↗

Cell-mediated immune responses in malnourished host.

One hundred children in the age group 6 months to 5 years were investigated for cell-mediated immune response in relation to their nutrition. The nutritional status was assessed by the Wellcome classification. The majority (54 per cent) of children had marasmus. Absolute lymphocyte count was found to be significantly low (P less than 0.01) in all malnourished groups except in mild forms of undernutrition. Small lymphocytes were also found to be significantly decreased (P less than 0.001) in malnourished children. A significant depression (P less than 0.001) was observed in the percentage and absolute T cells in all the malnourished children with kwashiorkor who showed the maximum depression of counts. All the control children showed DNCB skin reactions above grade 2+ while only 39 per cent of malnourished children showed reaction of this grade. After 4-6 weeks of dietary therapy, T cell counts were comparable with control values and DNCB skin test returned to normal in more than 75 per cent of cases.

Child, Preschool↗

Prognostic value of 'C' reactive protein in tuberculosis.

'C' reactive protein (CRP) levels were determined in 100 cases of tuberculosis and 30 age and sex matched children. Serial estimations, one and 3 to 6 months after initiation of therapy was done in 81 and 41 of these patients, respectively. Mean initial levels of CRP in tuberculosis group was 18.52 micrograms/ml while in the control group it was 2.77 micrograms/ml (p less than 0.001). The elevated CRP levels fell significantly to 5.93 micrograms/ml after one month of treatment (p less than 0.001) and by 3 to 6 months of treatment had fallen to normal values. The fall in CRP levels correlated with clinical response. It is concluded that CRP can serve as a sensitive indicator of activity of the disease and the return to normal values of initially elevated CRP levels may indicate a good therapeutic response.

C-Reactive Protein↗